Chest Pain Evaluation: Complimentary Role of Cardiac CT and MR Minh Nguyen MD, Christopher Klassen MD, PhD, Kiran Kareti, MD, Birgit Stolze, Alan Siuciak, Norbert Wilke, MD University of Florida, Jacksonville, Health Science Center, Department of Radiology and Cardiovascular Center Corresponding Author: Norbert Wilke, MD Associate Professor of Radiology Associate Professor of Medicine Chief, Cardiovascular MR and CT University of Florida Health Science Center 655 West Eighth Street Jacksonville, FL, 32209-6511 Call: 904-244-8723 Page: 904-306-4256 Fax: 904-244-3382

Introduction

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oronary artery disease (CAD) continues to be one of the leading causes of death in the United States. Each year, approximately 8 million patients are seen in the emergency room for chest pain. About 25% have acute MI or unstable angina, 25% have stable angina, and up to 50% have non-cardiac chest pain. The cost is over $3 billion for those without acute diseases. Unfortunately, at the same time, about 5% of patients with MI are sent home from the ER and results in 20% of malpractice payout. Guidelines such as TIMI Risk Score have been developed to allow triage of chest pain patients. Patients are-classified as low-risk (TIMI score